What should I look for in choosing a treatment center for a patient with a brain tumor, and why should I consider NYU?
It is important to find a center that can provide comprehensive care for patients with brain tumors. Such care is dependent on a number of factors. First, a center should have a neurosurgery department with members who specialize in the treatment of brain tumors. There should be strong departments of Oncology, Radiation Oncology, Neuroradiology, and Otolaryngology, as the services provided by members of these departments can be as important as those provided by the neurosurgeon. The facility should have the equipment and technology necessary to allow high level care, including both frameless and frame based stereotactic systems, neuroendoscopic equipment, and stereotactic radiosurgery equipment like the Gamma Knife system. NYU provides these and many other advantages in caring for patients with brain tumors. Probably the most important qualification, however, is volume. The NYU department of Neurosurgery treats more patients with brain tumors than any other single Neurosurgery department in the New York area.
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How do I find out if one of the NYU brain tumor specialists participates with my insurance plan?
At least one member of the department participates with most major insurance carriers. To find out who participates with your insurance plan ???
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What should I bring to the initial consultation?
Any recent MRI or CT scans should be brought to the initial consultation. If you have previously undergone surgery, it is very helpful to have scans from before and after surgery to compare. Keep in mind that the neurosurgeon will need to see actual films (either hard copy films or CD ROM format) and not just the written reports. Any related test results should be brought to this appointment as well - endocrine labs in the case of a pituitary tumor for example.
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Is it possible to see a neurosurgeon at NYU for a second opinion if I'm already being treated or have undergone surgery elsewhere?
Absolutely. If no surgical care is indicated, appropriate referrals may still be made to other members of our treatment team including radiation and neuro-oncologists.
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If I need surgery, what hospital will it be performed in?
Although the department covers three different major hospitals - Tisch Hospital (the University Hospital of NYU), Bellevue Hospital Center, and the Manhattan Veteran's Hospital - virtually all private patients are cared for at Tisch Hospital at NYU Medical Center
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Where is NYU Medical Center located?
NYU Medical Center is located at 530 First Ave between 30th and 34th streets. Both the hospital building and the physician's offices are located in adjoining buildings in this complex.
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If surgery is recommended, will further testing be necessary?
This depends on the circumstances of your specific case. In many cases a stereotactic MRI scan (one done with special markers placed on the scalp) will need to be done prior to surgery. In some instances this may be done prior to admission. Some cases will also require other testing such as cerebral angiography. At the minimum you will need to undergo routine presurgical testing. This involves basic lab tests, a chest X-ray, and an EKG. Most patients undergoing surgery for a brain tumor will also need to undergo medical or cardiac clearance at the discretion of the treating neurosurgeon.
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What time should I come into the hospital on the day of surgery?
The physician's office should contact you the day prior to surgery to tell you when to arrive. The OR schedule is released that afternoon. If you haven't been told what time to come in, call the doctor's office prior to 5pm on the day before surgery.
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How long will I need to be in the hospital? Off from work? Etc?
This depends on the type of tumor and the exact situation. In general, the hospital stay following a craniotomy is at least 3 days, but this varies significantly from case to case. The length of time to take off work or limit certain activities like driving is highly variable and must be discussed with the surgeon.
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Is there anything I should avoid prior to surgery?
Yes, any type of blood thinning medication should be discontinued prior to surgery. This includes aspirin as well as other antiplatelet medications. Many over the counter pain remedies such as ibuprophen and naproxen also have antiplatelet effects and should be avoided for several days prior to surgery. Even some vitamin supplements can have blood thinning effects. All medications you may be taking should be discussed with your surgeon at the time of the office visit to make sure that there are no contraindications to surgery. For most medications that affect the normal clotting mechanisms, simply discontinuing use at least 5 days prior to surgery will be recommended. In some circumstances where anticoagulation is very important (a patient taking coumadin for a mechanical heart valve, for example) special arrangements may need to be made to minimize the risks associated with stopping the medication. Most drugs, however, should be continued up to the time of surgery. It is OK to take regularly scheduled medications on the morning of admission with a small sip of water.
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Can I eat on the night prior to admission? What about that morning?
If you are scheduled for admission for surgery or an invasive diagnostic test such as a cerebral angiogram, you should have nothing to eat after midnight. Eating breakfast on the morning of admission is likely to result in postponement of your surgery. This is very important as the presence of even a small amount of food in the stomach greatly increases the risk of general anesthesia and other procedures. Aside from a sip of water that can be used to take morning medications, the patient must not eat or drink anything after midnight prior to admission.
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